Lima v. Marshall
Lima v. Marshall
Opinion of the Court
The following facts are not in dispute. On February 1, 2001, the plaintiff, Esmeralda Lima, suffered a whiplash injury when the car she was driving was struck by a vehicle driven by the defendant, Jack Marshall (the February accident). One month later, on March 2, 2001, after incurring $436.35 in medical expenses related to the February accident, but before
Lima continued treatment following the March accident, including but not limited to physical therapy, the purpose of which was to alleviate “the combined effects the two accidents had on [her] injuries and symptoms.” Lima’s medical expenses for all of her post-March accident treatment amounted to $4,937.02. With the exception of the three initial bills incurred prior to the March accident, which totaled only $436.35, none of Lima’s medical bills, reports, or records separate out her treatment or expenses between the two accidents.
Lima brought this action against Marshall and the owner of the car he was driving, defendant Katherine Bourgeois, generally alleging negligence and seeking to recover damages for pain and suffering proximately caused by the February accident.
Discussion. “An integral part of the statutory ‘no-fault’ insurance scheme is G. L. c. 231, § 6D, which conditions a plaintiff’s recovery for pain and suffering on the determination that his reasonable and necessary medical expenses are in excess of [$2,000], unless the accident-related sickness or injury falls into one of five defined categories.”
In order to determine whether there is a question for the jury on the threshold amount, we must look beyond the expenses to both the injury claimed by Lima and the treatment she sought as a result of the defendants’ negligence. In this regard, the burden would be on Lima to establish at trial, by a preponderance of the evidence, that the treatment underlying her expenses was “necessary,” i.e., that it “legitimately arose out of the injury claimed by [her]” in the February accident.
A fair reading of Lima’s complaint, combined with materials Lima provided in response to the defendants’ motion for summary judgment, all indicate that the only injury for which she sought treatment as a consequence of the defendants’ negligence in causing the February accident is a whiplash injury. Consequently, we may only consider the treatment that “legitimately arose out of” the whiplash injury of February 1, 2001, in determining what, if any, related medical expenses can be used to meet the threshold amount.
Lima, however, failed to document, as was her burden — with supporting bills, records, or reports — what treatment subsequent to the March accident “represented a bona fide effort to alleviate and ameliorate” the February whiplash injury. Additionally, she failed to demonstrate, for purposes of avoiding summary judgment, which of her medical expenses incurred after the March accident were associated with the treatment for whiplash and whether those expenses exceeded $2,000 when combined with those she incurred in February.
Alternatively, Lima argues that a genuine issue of material fact exists whether she would have amassed an amount exceeding the requisite $2,000 had the March accident not occurred. Notwithstanding the question whether § 6D allows such anticipated expenses to qualify toward the threshold,
Judgment affirmed.
Lima’s claims against the driver involved in the March accident were settled.
Relevant here, G. L. c. 231, § 6D, as amended by St. 1988, c. 273, § 55, generally provides: “In any action of tort . . . arising out of the ownership, operation, maintenance or use of a motor vehicle within this commonwealth by the defendant, a plaintiff may recover damages for pain and suffering, including mental suffering associated with such injury . . . only if the reasonable and necessary expenses incurred in treating such injury . . . for neces
A plaintiff must also show that such expenses are reasonable, a matter that is not at issue in this case.
Lima argues, relying on Wallace v. Ludwig, 292 Mass. 251 (1935), that the defendants are liable for all expenses associated with the treatment of her injuries aggravated by the March accident. In Wallace, the plaintiff was injured in a car accident but died many months later due to complications arguably associated with the injuries she suffered as a result of the accident. Wallace held that “where an injury arising from a cause which entails liability on the defendant combines with a . . . subsequently acquired disease, the person liable for the injury is liable also for the resulting aggravation.” Id. at 256. Even were we to accept the application of the principles discussed in Wallace to the events presented here, it would avail the plaintiff nothing. The March accident caused distinct injuries to other parts of Lima’s body (low and middle back) not injured in the February accident. Lima’s summary judgment submission fails to distinguish those treatments and expenses associated with the injuries aggravated by the March accident (neck and upper back pain) from those which were exclusively caused by the March accident (low and middle back pain).
The Supreme Judicial Court left open the question whether “medical and similar expenses not incurred at the time of trial but whose incurrence is reasonably to be expected may count toward the [statutory] threshold.” Phelps v. MacIntyre, supra at 465 n.6.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.